Affordable Care Act and Medi-Cal Support in Orange County and California
If there is repeal or major modifications to Federal support of the Affordable Care Act in California’s Medi-Cal, there will be serious impacts to Orange County and California health care and budgets. We present a brief economic overview of the current ACA Medi-Cal program in Orange County and California.
In Orange County, California, we have CalOptima, which is a COHS or County Organized Health System for Medi-Cal, which serves people with low income and limited ability to pay. As of Nov. 2016, this covers 771,000 patients. This is out of the Orange County population of 2.97 million, which then has 26% on Medi-Cal.
The State of California has 10.6 million covered by Medi-Cal, out of a population of 39.5 million, or 27% of the state’s population.
The costs of Medi-Cal in California for 2014-2015 were $73.9 billion, including $16.9 billion in state funds. This is to be compared to the California Budget of $156 billion, with $108 billion in general funds, the rest being in bonds. The $16.9 billion is then 15.6% of the state budget.
The federal coverage follows complicated rules for different sectors, but for newly eligible ACA participants from 2014 to 2016, the federal government covers 100% of the costs. Beginning in 2017, the federal coverage is 95%, phasing down to 90% by 2020, and from then on. Amazingly, many conservative Republican states have rejected this federal aid, citing the 10% that they will have to pay after 2020. And of course promising to repeal Obamacare. California historically has not recovered its total federal contribution in taxes, so this is part of that redress.
For families to qualify for Medi-Cal, their income has to be below 138% of the federal poverty level. For the contiguous 48 states, the federal poverty rate is, followed by 138% of the rate:
1 person: $11,770; $16,243
2 people: $15,930; $21,983
3 people: $20,090; $27,724
4 people: $24,250; $33,465
With $4,160; $5,741 for each additional person in the family.
For a standard work week job of about 2,000 hours a year, a $10 an hour wage gives $20,000 a year. A $12.50 an hour wage gives $25,000 a year, and a $15 per hour wage gives $30,000 per year. Workers whose families earn those wages would respectively qualify for Medi-Cal with 2, 3, or 4 dependents.
The California poverty rate is 20.6%, the highest of any state. The US rate is 13.5%, corresponding to 43.1 million Americans. This includes 14% of seniors, and 18% of children in the US.
The US has the weakest social safety net of all developed countries.
Canada adopted Universal Health Care in 1966. That was 50 years ago.
California has the greatest vulnerability, therefore, of any state to changes in the ACA which are not positive in coverage. We must all inform our Senators and Representatives of the importance of protecting federal support for health care, and the taxes which support it.
